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Old 02-07-2018, 02:26 PM   #1 (permalink)
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I REALLY hate our medical system!!!!

Yesterday:
Get a medical bill with a pretty obvious mistake on it so goes on my todo pile to call them in the morning.

Today:
Call hospital, find out they need a FORM from my spouse to talk to them. She can give permission over the phone while form is in the mail though.

Call spouse and tell her everything so she calls them to give permission.

Call hospital, they blame insurance company.

Call insurance company, they blame hospital, tell me what they need.

Call hospital who tell me the permission was valid for 1 call only! After I point out this is a continuation of the first call they tell me I need to talk to the doctor .... who nobody has ever heard of.

I give up, spouse is tilting at that windmill now because at least she knows who she saw and for what.

Well, so much for getting work done today.
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Old 02-07-2018, 05:33 PM   #2 (permalink)
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The one that drives me nuts the most is when a doctor is covered, but only if they bill a certain way (ie through hospital instead of directly).

ITS THE SAME DOCTOR.
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Old 02-07-2018, 06:55 PM   #3 (permalink)
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Took my sister to a doctors appointment today as she just had knee surgery a few days ago. She has colitis and is having a flare. She hasn't eaten since Saturday because everything causes severe pain.

Doc sent in a script for a medication to help with the colitis. Drove back to our town, went to the drug store and they said the would have to order it in for tomorrow and that it would be $295.00! My sis said, no, I have insurance. They said, well that's the price with insurance, without insurance it is $1,600.00....a month!

She said no thank you, I don't have that much money. We left and now she has no meds and still has the pain and cannot eat. I would pay for it if I could afford it, but no.

She is going to call the doc tomorrow and see if there are any other meds that don't cost so much.

I hate insurance companies and drug companies.
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Old 02-07-2018, 09:34 PM   #4 (permalink)
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Originally Posted by Ramen Jedburgh View Post
The one that drives me nuts the most is when a doctor is covered, but only if they bill a certain way (ie through hospital instead of directly).

ITS THE SAME DOCTOR.
Actually, the thing the insurance company did not like is the dr was 'too vague' in what the charge was. In other words, they did not use enough decimal points in the charge code.

I really wish we had the full indemnity insurance still as an option. The only one who should need your full medical history is your doctor and anyone concerned (like a spouse).
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Old 02-07-2018, 09:38 PM   #5 (permalink)
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Originally Posted by Kelley Wonder View Post
Took my sister to a doctors appointment today as she just had knee surgery a few days ago. She has colitis and is having a flare. She hasn't eaten since Saturday because everything causes severe pain.

Doc sent in a script for a medication to help with the colitis. Drove back to our town, went to the drug store and they said the would have to order it in for tomorrow and that it would be $295.00! My sis said, no, I have insurance. They said, well that's the price with insurance, without insurance it is $1,600.00....a month!

She said no thank you, I don't have that much money. We left and now she has no meds and still has the pain and cannot eat. I would pay for it if I could afford it, but no.

She is going to call the doc tomorrow and see if there are any other meds that don't cost so much.

I hate insurance companies and drug companies.
Pay attention to the numbers on the bottle. Guarantee it is not for a month's supply but for 30 days. So for 5 months in the year you are SOL for one of those days and it is even worse if you *gasp* lose a pill.
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Old 02-07-2018, 11:15 PM   #6 (permalink)
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Kelly, call around. The price of the same meds can vary wildly from pharmacy to pharmacy.
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Old 02-08-2018, 05:29 AM   #7 (permalink)
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Kelly, call around. The price of the same meds can vary wildly from pharmacy to pharmacy.
Also google it. Often you can find coupons for the med. Talk to the prescribing doctor to as they are often given samples (which they have no real use for) to convince them to prescribe it.
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Old 02-08-2018, 05:49 AM   #8 (permalink)
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The one that drives me nuts the most is when a doctor is covered, but only if they bill a certain way (ie through hospital instead of directly).

ITS THE SAME DOCTOR.
This will come down to the biller/coder's fault (because Doctor's tend not to take the blame for anything in order to limit their liability and protect their image). Not enough experience at it or didn't take the time to do it right. I used to be one. Each insurance company has it's own set of rules on top of what Medicare/Medicaid tells them is essential and they continually change the rules in efforts to limit the cost to them. If the biller/coder comes across an insurance type they are unfamiliar with they will just send in the bill and hope for it to go through, due to time constraints. Time constraints are usually a product of an office that is trying to make do with less experienced and cheaper labor. When I first started out, I tried to be ethical in my coding...for example, if a doctor only saw a patient for 15 minutes that was what I tried to bill for...but the truth of the matter was that I should have billed them for an hour because it took numerous calls and re-reads/verifications of the doctor's notes to get the right diagnosis codes, which led to significantly more time being consumed by the office than what was being billed for, despite what Medicare/Medicaid said should be the right amount of time for a particular office visit.
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Old 02-08-2018, 06:00 AM   #9 (permalink)
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Took my sister to a doctors appointment today as she just had knee surgery a few days ago. She has colitis and is having a flare. She hasn't eaten since Saturday because everything causes severe pain.

Doc sent in a script for a medication to help with the colitis. Drove back to our town, went to the drug store and they said the would have to order it in for tomorrow and that it would be $295.00! My sis said, no, I have insurance. They said, well that's the price with insurance, without insurance it is $1,600.00....a month!

She said no thank you, I don't have that much money. We left and now she has no meds and still has the pain and cannot eat. I would pay for it if I could afford it, but no.

She is going to call the doc tomorrow and see if there are any other meds that don't cost so much.

I hate insurance companies and drug companies.
If you contact the drug company they may provide it for free. My step-father has some stupid expensive drug he takes that he gets for free from the drug company.
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Old 02-08-2018, 06:51 AM   #10 (permalink)
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Of course the drug companies are not giving it for free out of the goodness of their hearts .... they want to get a customer.

edit: It is basically like a pusher giving away the first bag of something.
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Old 02-08-2018, 07:25 AM   #11 (permalink)
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This will come down to the biller/coder's fault (because Doctor's tend not to take the blame for anything in order to limit their liability and protect their image). Not enough experience at it or didn't take the time to do it right. I used to be one. Each insurance company has it's own set of rules on top of what Medicare/Medicaid tells them is essential and they continually change the rules in efforts to limit the cost to them. If the biller/coder comes across an insurance type they are unfamiliar with they will just send in the bill and hope for it to go through, due to time constraints. Time constraints are usually a product of an office that is trying to make do with less experienced and cheaper labor. When I first started out, I tried to be ethical in my coding...for example, if a doctor only saw a patient for 15 minutes that was what I tried to bill for...but the truth of the matter was that I should have billed them for an hour because it took numerous calls and re-reads/verifications of the doctor's notes to get the right diagnosis codes, which led to significantly more time being consumed by the office than what was being billed for, despite what Medicare/Medicaid said should be the right amount of time for a particular office visit.
Yeah, it tends to seem to be the case. Mostly it results in a lot of calls and trying to get a new bill issued properly, which usually works. Its just a pain in the ass.

I also hate how every little department and person sends a separate bill. Bill for the person doing the test, bill for the person reading the test, bill for the person who did some lab work in between. Its nuts how many bills hospital visits can get.

I don't really talk about it around here because SL is essentially my "goto escape", but my youngest daughter (17) has a rediculous number of medical issues and I have gotten more exposure to hospitals and doctors than I would want to inflict on my worst enemy. The whole system is broken as hell by paperwork and middlemen and beurocratic nonsense and it takes way more work to navigate than it should. You alsp have to pre plan a lot if you need anything super serious to check for in network out of network bull shit even though hey, we were referred here by our regular person and I imagine some doctor has a better idea of whats good over some leeching insurance company that is more interested in profit than patient care.

Anyway, enough ranting. I don't see the system changing to be at all better for at least another 5-10 years even if the GOP gets evicted. If it ever changes.
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Old 02-08-2018, 07:47 AM   #12 (permalink)
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Yes, between my time, my spouse's time, the hospital's time, and my insurance company's time yesterday it was a day of phone trees when myself and my spouse were trying to get work done. Now is the waiting game for the hospital to recode it, submit it, and the insurance company to process it. Fortunately it would not be the end of the world for us if we had to pay the whole thing out of pocket (although it does make me wonder why I am paying for insurance) but it is the wasted time and effort that is the thing I am annoyed with.

The separate bill thing ..... ugh. Just when you thought something was done and you can get back to your life the bill from, oh, the gas passer (anesthesiologist) arrives and you find out it is coded wrong as well so it is back to step A again.

Ugh, hope your daughter is ok. Yes, things like having to get pre-clearance before a hospital admission are the definition of WTF. If you or a family member is in the ER and they call for a hospital admission stat the last thing you will think to do is call your insurance company before they get wheeled upstairs. You might think of it after the first time but it is not like you are about to let some paper pusher override the medical judgement of a doctor on the spot.
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Old 02-08-2018, 10:19 AM   #13 (permalink)
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I really wish we had the full indemnity insurance still as an option. The only one who should need your full medical history is your doctor and anyone concerned (like a spouse).
I can't speak for private insurance companies, but I can tell you why managed care needs your full information.

My company mostly does Medicaid and Medicare, and State governments (and federal for Medicare) have vast reporting requirements for us to prove we are taking care of their members and spending money wisely. If we spend a lot on a population, we have to prove they really are that sick.

I think the only way you can avoid this is to have everyone managed by insurers, or a government agency, that aren't accountable to anyone, which sounds worse to me.
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Old 02-08-2018, 10:40 AM   #14 (permalink)
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Why would that be worse? I am all for a single payer plan like Bernie has been espousing.

This is not about reporting requirements. The insurance company wanted a more exact charge code to pay me, the provider sounded like they used one that was too generic. If the regs say you need to get *that* fine in your detail that you are basically handing personally identifiable information to a regulator the regs need to be changed.
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Old 02-08-2018, 10:57 AM   #15 (permalink)
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I am not opposed to the idea of people needing more info myself. Though I do worry about it with insurance companies using it to jack up rates etc.

I am kind of amazed that there doesn't seem to be a centra repository for all medical data yet. Its a pain in the ass when a dozen hospitals all have their own records.
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Old 02-08-2018, 11:15 AM   #16 (permalink)
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Why would that be worse? I am all for a single payer plan like Bernie has been espousing.

This is not about reporting requirements. The insurance company wanted a more exact charge code to pay me, the provider sounded like they used one that was too generic. If the regs say you need to get *that* fine in your detail that you are basically handing personally identifiable information to a regulator the regs need to be changed.
Universal healthcare all over the world strictly enforces cost cutting measures. Other countries spend less of their GDP on healthcare because they nitpick the all bloody hell out of what providers and payers do. Single payer does not mean blank checks and no questions asked.

All over the world, providers are expected to prove it was necessary if they want the insurer, or government to pay for it.

I know this is really, REALLY annoying. The only solution I can see is if technology eventually makes most healthcare so cheap that everyone pays out of pocket.

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I am kind of amazed that there doesn't seem to be a centra repository for all medical data yet. Its a pain in the ass when a dozen hospitals all have their own records.
My job would be easier if this existed, but it would be a major security issue to have that much protected data in one place. The military intentionally got rid of central databases in response to the Snowden leaks.
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Old 02-08-2018, 11:30 AM   #17 (permalink)
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My job would be easier if this existed, but it would be a major security issue to have that much protected data in one place. The military intentionally got rid of central databases in response to the Snowden leaks.
Yeah, see the equifax break-in and others. Most of those attacks did not get any more serious data than SSNs but what happens if you start getting into some serious PII data?

Probably the best approach would be something like a phone app that has all of your own data so when you go to a new doctor you have a copy of everything about you, right up to your latest x-rays, but by no means do you want to make a motherlode that says 'attack me'.

Logistically it would be challenging as well. Up until a few decades ago all medical records were hand transcribed then eventually stored on microfiche. On a whim I decided to read my complete medical record through grad school (about when my MR in my home state ended). The mid 70's and earlier meant some serious deciphering skills while puzzling out the latin for something.
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Old 02-08-2018, 11:44 AM   #18 (permalink)
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Yeah, see the equifax break-in and others. Most of those attacks did not get any more serious data than SSNs but what happens if you start getting into some serious PII data?

Probably the best approach would be something like a phone app that has all of your own data so when you go to a new doctor you have a copy of everything about you, right up to your latest x-rays, but by no means do you want to make a motherlode that says 'attack me'.

Logistically it would be challenging as well. Up until a few decades ago all medical records were hand transcribed then eventually stored on microfiche. On a whim I decided to read my complete medical record through grad school (about when my MR in my home state ended). The mid 70's and earlier meant some serious deciphering skills while puzzling out the latin for something.
The phone app would be cool...

I want us to go to a universal, multipayer system like Germany. The government buys you insurance if you can't afford it yourself, and their are enough insurers so you can't get everyone's data just by hacking one.

We also have extremely high penalties for leaks, which is good. My company invests greatly into data security because we have that huge incentive.
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Old 02-08-2018, 12:13 PM   #19 (permalink)
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The phone app would be cool...

I want us to go to a universal, multipayer system like Germany. The government buys you insurance if you can't afford it yourself, and their are enough insurers so you can't get everyone's data just by hacking one.

We also have extremely high penalties for leaks, which is good. My company invests greatly into data security because we have that huge incentive.
While it is specialized I like EpiDiary .... all the key info (meds, a calendar of seizures and doctor visits, etc). Suited for the purpose but for a pocket MR you would want something generic while also not just being a blank word processing document. Probably a high-level view of the common things an intake form would want (last dr visit, meds, etc) and your MR. Of course now I am thinking of how to design the thing.
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Old 02-08-2018, 12:29 PM   #20 (permalink)
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It looks like there are already phone apps out there. I need to do some digging as what I want is a way to have a complete record without being tied to some centralized database.
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Old 02-08-2018, 07:20 PM   #21 (permalink)
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Pay attention to the numbers on the bottle. Guarantee it is not for a month's supply but for 30 days. So for 5 months in the year you are SOL for one of those days and it is even worse if you *gasp* lose a pill.
CVS does auto-refill for me about every four weeks. A few extra bucks for them, and I build up a bit of a reserve supply. You need that reserve supply, because randomly "the doctor has to authorize the perscription" or some such, which holds things up.
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Old 02-08-2018, 07:29 PM   #22 (permalink)
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It looks like there are already phone apps out there. I need to do some digging as what I want is a way to have a complete record without being tied to some centralized database.
Phone apps would be hackable because phones are connected to the Internet. It would be better to have a data bracelet or necklace that's normally unplugged, except when being updated by a doctor's office, or being read by paramedics in an emergency. Stupidly large amounts of data will fit on a chip the size of a fingernail, so such devices don't need to be large.
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Old 02-08-2018, 08:49 PM   #23 (permalink)
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Phone apps would be hackable because phones are connected to the Internet. It would be better to have a data bracelet or necklace that's normally unplugged, except when being updated by a doctor's office, or being read by paramedics in an emergency. Stupidly large amounts of data will fit on a chip the size of a fingernail, so such devices don't need to be large.
The problem with a bracelet, necklace, or other wearable, is that they can be easily misplaced or stolen. Probably a better idea to have it in an injectible microchip.
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Old 02-08-2018, 09:36 PM   #24 (permalink)
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[QUOTE=TrollCampFollower;2446468]Universal healthcare all over the world strictly enforces cost cutting measures. Other countries spend less of their GDP on healthcare because they nitpick the all bloody hell out of what providers and payers do. Single payer does not mean blank checks and no questions asked.

All over the world, providers are expected to prove it was necessary if they want the insurer, or government to pay for it.

I am in Canada and this is not true. Yes there is some criteria for some procedures like knee, hip replacements but in general I have only heard once that a procedure is not covered and it was for wart removal. I had a minor procedure (that in the US I would probably still be waiting for it to be approved). I had a reaction and was re-admitted they did X-ray , and EKG, and a CT scan. Nothing showed up and I was release. I had an Ultra-sound later that week and a follow up appointment. Time spent consulting an insurance company none. Cost to me Parking at the hospital I think it was about $20.00.

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Old 02-08-2018, 11:28 PM   #25 (permalink)
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